Adv Physiol Educ 32: 142146, 2008;

doi:10.1152/advan.00095.2007.

How We Teach

Common student misconceptions in exercise physiology and biochemistry

James P. Morton, Dominic A. Doran, and Don P. M. MacLaren
Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
Submitted 24 October 2007; accepted in final form 28 January 2008

Morton JP, Doran DA, MacLaren DP. Common student misconceptions in exercise physiology and biochemistry. Adv Physiol Educ 32:
142146, 2008; doi:10.1152/advan.00095.2007.The present study
represents a preliminary investigation designed to identify common
misconceptions in students understanding of physiological and biochemical topics within the academic domain of sport and exercise
sciences. A specifically designed misconception inventory (consisting
of 10 multiple-choice questions) was administered to a cohort of level
1, 2, and 3 undergraduate students enrolled in physiology and biochemistry-related modules of the BSc Sport Science degree at the
authors institute. Of the 10 misconceptions proposed by the authors,
9 misconceptions were confirmed. Of these nine misconceptions, only
one misconception appeared to have been alleviated by the current
teaching strategy employed during the progression from level 1 to 3
study. The remaining eight misconceptions prevailed throughout the
course of the degree program, suggesting that students enter and leave
university with the same misconceptions in certain areas of exercise
physiology and biochemistry. The possible origins of these misconceptions are discussed, as are potential teaching strategies to prevent
and/or remediate them for future years.
prerequisite knowledge; metabolism; sport science

(SES) is one of the fastest growing

academic disciplines in the United Kingdom. By definition,
SES is the application of scientific principles to the promotion, maintenance and enhancement of sport and exercise
related behaviours (4). From a teaching and research perspective, SES is primarily concerned with the scientific study of
sporting performance or that of how regular exercise can
promote health and well-being. The subject further encompasses the subdisciplines of physiology, biochemistry, psychology, sociology, biomechanics, and motor learning, to
which one of these students will typically direct their attention
as their studies develop. Although SES is undergoing rapid
growth as an academic discipline, available educational research directed toward improving the teaching of SES within
the United Kingdom is limited (18, 19).
Of all the subdisciplines of SES, students typically report
they have greatest difficulties when studying exercise physiology and biochemistry, despite these being the most popular areas of SES. This is perhaps not surprising given the
factual and conceptual difficulties of the topics and also the
rate at which ongoing research is contributing to existing
knowledge. For example, the introduction of molecular
biology to exercise physiology and biochemistry has presented itself as another major challenge for both student and
teacher. Students are now expected to understand whole
body physiological responses to acute and chronic exercise

SPORT AND EXERCISE SCIENCE

Address for reprint requests and other correspondence: J. Morton, School of

Sport and Exercise Sciences, Liverpool John Moores Univ., 15-21 Webster St.,
Liverpool L3 2ET, UK (e-mail: J.P.Morton@ljmu.ac.uk).
142

while also having an appreciation for the molecular mechanisms underpinning these adaptations.
In teaching exercise physiology and biochemistry disciplines, many lecturers often assume that students are familiar with the basics because of they have already satisfied
course prerequisites. We assume that because students have
completed school or college qualifications in biology, chemistry, or physical education that they will therefore be able
to benefit from the teaching of advanced content during
higher education. On the basis of this assumption, we subsequently devise educational objectives and teaching strategies for the relevant course. We also assume that as
students progress through their studies at university, what
they learn in modules studied at level 1 will prepare them for
level 2 and, finally, level 3. However, when collectively reflecting on our teaching experience, we have frequently observed that merely satisfying course and module prerequisites
does not ensure an understanding of basic physiological and
biochemical concepts.
The aims of the present preliminary study were to expand
the misconception literature [readers of this journal will be well
acquainted with such literature (see Refs. 13, 14, 16, 17, and
20)] by attempting to identify those common misconceptions
experienced by SES students while studying exercise physiology and biochemistry components of their degree. By distributing multiple-choice questionnaires (and also requesting justification for chosen answers) to level 1, 2, and 3 students, we
attempted to track the prevalence of these misconceptions
throughout their degree progression.
METHODS

Misconceptions inventory. At a meeting of the authors, a list of

common misconceptions on various aspects of exercise physiology
and biochemistry was compiled. This list was drawn from the authors
previous experiences of interacting with students in the classroom and
office and from formal marking of coursework tasks and examinations. Statements of these misconceptions are shown in Table 1. These
misconceptions were subsequently incorporated into a questionnaire
that presented 10 multiple-choice questions detailing those misconceptions outlined in Table 1. Students were also provided with space
to justify their reasoning for their answers so as to provide the authors
with a further understanding of any misconceptions identified. The
Misconceptions Inventory questionnaire is shown in Table 2 together with a full breakdown of student responses.
Populations surveyed. A sample of students enrolled in physiologyand biochemistry-related modules in the BSc (Hons) Sports Science
degree at Liverpool John Moores University participated in the
investigation. Students from levels 1 to 3 participated in the study so
as to gain an understanding of the prevalence of any misconceptions
throughout the course of the degree program. Students were not
asked to volunteer, and the exercise was presented as a compulsory
part of the course, which served to act as a catalyst for promoting
revision for end of year examinations. Demographic information of

1043-4046/08 $8.00 Copyright 2008 The American Physiological Society

How We Teach
COMMON STUDENT MISCONCEPTIONS IN EXERCISE PHYSIOLOGY AND BIOCHEMISTRY

Table 1. Potential student misconceptions on aspects of

exercise physiology and biochemistry as recognized by the
authors experiences of teaching these topics
Potential Student Misconceptions

1. Lactate is only produced when muscle contracts under anaerobic

conditions.
2. Lactate causes fatigue.
3. Fat is only used as an energy source during exercise when
carbohydrate sources run out.
4. To maximize fat loss during exercise, exercise intensity should be
high.
5. The process of muscle contraction consists solely of peripheral
processes.
6. When a muscle shortens in length during contraction, the A-band
also shortens.
O2max is the most important determinant of endurance performance.
7. V
8. Oxidation reactions only involve oxygen molecules.
9. Blood pressure is higher during prolonged exercise in hot conditions
compared with normal conditions.
10. Brain blood flow increases during exercise.
O2max, maximal oxygen uptake.
V

the students studied is shown in Table 3, along with their educational background.
RESULTS

Of the 10 misconceptions proposed by the authors, 9 misconceptions appeared to be prevalent among the populations
studied (there was no evidence of any misconceptions regarding brain blood flow during exercise; data not shown). The
percentage of the student population at each level of study who
displayed misconceptions is shown in Table 4. A comprehensive analysis of student answers is also shown in Table 2.
Lactate misconceptions. The data demonstrated that 85%,
80%, and 60% of the population studied at levels 1, 2, and 3,
respectively, responded with a misconception concerning the
understanding of cellular conditions that result in lactate production during muscle contraction (question 1). In relation to
the function of increased lactate production (question 2), there
was a linear decrease in the prevalence of misconceptions from
levels 1 to 3. In general, students at levels 1 and 2 misconceived
lactate to be a dead-end waste product that causes fatigue or
will produce hydrogen ions that cause fatigue. In level 3, only
19% of the population responded with a misconception,
whereas 81% of students correctly understood lactate to be an
important energy-yielding substrate. These data demonstrate
that as lactate metabolism is studied in more detail as the
degree program progresses, students successfully appreciate
lactate as a metabolite as opposed to a possible fatiguing agent.
Nevertheless, students do not appear to appreciate or become
aware that lactate can also be produced during oxygenated
conditions.
Fat metabolism misconceptions. Misconceptions concerning
the optimal exercise intensity to oxidize lipids during exercise
(question 3) were made by 44% (level 1), 43% (level 2), and
72% (level 3) of the population studied. Greater than 95% of
the population at levels 13 showed misconceptions regarding
the interaction of fat and carbohydrate metabolism during
exercise (question 4). In this situation, all students clearly
misconceived that skeletal muscle will only utilize fat as a fuel
source during exercise when carbohydrate stores have been

143

reduced due to depletion of muscle glycogen, blood glucose, or

a combination of both.
Muscle contraction misconceptions. In relation to the process of muscle contraction (question 5), 84% (level 1), 75%
(level 2), and 90% (level 3) of the student population responded
with answers AD, which focused solely on peripheral processes. This question, however, may have been misunderstood
by students, as only 6% (level 1), 25% (level 2), and 10% (level
3) of the population correctly chose answer E (other), where
all of these students correctly explained that muscle contraction
begins with an impulse from the brain. It is acknowledged that
if this option had been explicitly available for selection (as
opposed to other), more students may have chosen this
answer. Nevertheless, these data demonstrate that only 6 25%
of the students appreciated the importance of the central
nervous system in voluntary muscle contraction. In answering
question 6, 56% (level 1), 50% (level 2), and 57% (level 3) of
students responded with a misconception concerning what
happens to components of the sarcomere during a shortening
contraction. In these instances, the majority of misconceived
responses assumed that the A-band will also shorten during a
contraction. Approximately 50% of all students, therefore, do
not appear to understand the mechanics of muscle contraction.
Determinant of endurance performance misconceptions. Misconceptions concerning the most important predictor of endurance running performance (question 7) were made by 63%,
84%, and 68% of level 1, 2, and 3 students, respectively. The
most prevalent misconception was that maximal oxygen uptake
O2 max) is the most important determinant. Only 37% (level
(V
1), 16% (level 2), and 32% (level 3) of the population correctly
cited the lactate threshold as the most important determinant of
endurance performance.
Oxidation reaction misconceptions. Misconceptions concerning the nature of an oxidation reaction (question 8) were
made by 81%, 61%, and 67% of level 1, 2, and 3 students,
respectively. The most prevalent misconception was that oxidation reactions involve the loss (or gain) of an electron solely
from (or by) an oxygen molecule. Students therefore appeared
to misconceive that any biological substance can be oxidized or
that oxidation reactions are the loss of an electron (as opposed
to gain) from the particular substance.
Blood pressure regulation misconceptions. Misconceptions
concerning blood pressure responses during exercise in hot
ambient conditions that induce dehydration (question 9) were
made by 78%, 54%, and 80% of level 1, 2, and 3 students,
respectively. These data demonstrate that students do not
appear to understand how blood pressure is regulated and
responds to exercise.
DISCUSSION

The aim of the present preliminary study was to identify

common misconceptions in students understanding of physiological and biochemical concepts of SES. Using a specifically
designed multiple-choice questionnaire, the present data identified nine misconceptions in understanding. Of these nine
misconceptions, only one misconception appeared to have
been alleviated by the present teaching strategy.
Potential sources of misconceptions. Potential sources of
misconceptions are often quoted as having arisen in the classroom, from textbooks or from an experience in the real world

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COMMON STUDENT MISCONCEPTIONS IN EXERCISE PHYSIOLOGY AND BIOCHEMISTRY

Table 2. Summary of student responses

Question

1. Lactate is produced during muscle contraction:

A. when the cell contracts under oxygenated conditions.
B. when there is a shortage of oxygen supply.
C. during anoxic conditions.
D. all of the above.*
E. other.
2. Lactate produced during muscle contraction:
A. is a dead end waste product.
B. is a dead end waste product that causes fatigue.
C. is an important energy-yielding substrate.*
D. will produce lactate ions, which cause fatigue.
E. does none of the above.
3. To maximize fat loss during exercise, it is necessary to exercise at the intensity at which fat oxidation
will be highest. For a sedentary individual, this typically occurs at:
O2max.
A. 45% V
O2max.
B. 4654% V
O2max.*
C. 5565% V
O2max.
D. 6675% V
O2max.
75% V
4. During prolonged exercise, skeletal muscle will predominantly use fat as an energy source when:
A. there is reduced carbohydrate availablity due to depletion of muscle glycogen stores.
B. there is reduced carbohydrate availability due to depletion of blood glucose stores.
C. there is reduced carbohydrate availability due to both of the above.
D. there is an increased availability of fatty acids within the muscle.*
E. all of the above.
5. The process of muscle contraction begins with:
A. propagation of an action potential along the sarcolemma.
B. acetylcholine transport across the synaptic cleft.
C. calcium release from the sarcoplasmic reticulum.
D. calcium binding to troponin C.
E. other.*
6. During muscle contration, when the muscle is shortining in length, the A-band will:
A. shorten.
B. lengthen.
C. remain unchanged.*
7. The most important predictor of endurance running performance is:
O2max.
A. V
B. lactate threshold.*
C. maximal cardiac output.
D. muscle size.
E. other.
8. An oxidation reaction consists of:
A. loss of an electron from an oxygen molecule.
B. gain of an electron by an oxygen molecule.
C. loss of an electron from any biological substance.*
D. gain of an electron from any biological substance.
E. other.
9. During prolonged continous exercise, blood pressure will initially increase (within the first 10 min)
above resting levels and should remain constant at the exercise pressure thereafter. When a subject
is nearing the end of his run on a hot afternoon (30C), which induces significant dehydration, his
blood pressure will therefore:
A. remain constant at the initially acquired exercise pressure.
B. decrease to below the initially acquired exercsie pressure but remain above resting levels.*
C. increase to above the initially acquired exercise pressure.

Level 1

Level 2

Level 3

3
80
2
15
0

3
74
3
20
0

0
60
0
40
0

3
37
13
46
1

0
23
50
27
0

0
0
81
13
6

9
8
56
23
4

5
19
57
19
0

25
34
28
7
6

20
11
64
0
5

11
3
54
5
27

10
3
32
3
52

54
24
13
3
6

46
19
5
5
25

48
23
16
3
10

43
13
44

25
25
50

43
14
43

41
37
17
3
2

74
16
10
0
0

58
32
7
0
3

34
39
19
6
2

29
11
39
13
8

30
20
33
13
4

40
22
38

33
46
21

42
20
38

Values are percentages of the student population. *Correct answer.

(13, 16). It is difficult to precisely state the origins of the

misconceptions identified here, and it is also possible that
sources may be different between the level 13 populations
sampled. For example, the level 1 students studied here had not
been exposed to any exercise science during their first year
of study but rather were exposed to those physiological
foundations deemed necessary before embarking upon exercise physiology in level 2 study. In this regard, it is tempting
to speculate that misconceptions identified in level 1 students
may be simply due to no previous knowledge (or exposure) of
exercise science. Misconceptions in these students may have

therefore arisen from experiences outside of the classroom.

However, considering that 50% and 70% of this population
had completed school or college study in biology and physical
education, respectively, it is somewhat concerning that students entered university with large misconceptions in areas
such as mechanics of muscle contraction, lactate metabolism,
and integration of lipid and carbohydrate metabolism. Furthermore, it is even more worrying that misconceptions were still
prevalent in level 2 and 3 study, despite the increased emphasis
on exercise science as the curriculum developed. Misconceptions in lactate metabolism appeared to have been somewhat

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Table 3. Description of the student population surveyed

Level 1

Level 2

Level 3

Number of students
80
64
42
Gender, %male/%female
70/30
81/19
70/30
Age, yr
20 4
20 1
21 1
Title of module in which
Physiological Exercise
Muscle
subjects were studied
Foundations
Physiology
Metabolism
Prior biology, %
52
56
83
Prior chemistry, %
11
12
13
Prior physical education, %
73
75
73
Prior Natural Diploma in
Sports Science/Studies, %
22
2
13

alleviated from the present teaching approach, although there is

still definite room for improvement. Nevertheless, the prevalence of misconceptions from level 1 to 3 study indicates that
the present classroom and laboratory teaching strategies do not
appear to be achieving the the desired outcomes. In agreement
with Michael et al. (16), it is clear that something we do or say
in the classroom or include in our written materials will
contribute to students developing a misconception.
One such activity has been suggested to be the imprecise use
of language by teachers and students (22). Jacobs (8) also
noted that every science discipline uses terms from everyday
(lay) language that have special meanings within the discipline,
e.g., elasticity. Incorrect use of such terms may therefore lead
to the formation of a misconception. Visual representations in
the classroom (22) and oversimplified analogies (6) have also
been proposed as origins of misconceptions in science. With
this in mind, it is apparent that we must strive for precision and
clarity in our words (or visual aids) so that what we seek to
communicate is actually what is communicated.
In addition to classroom practices, it is also possible that
many misconceptions may be due to conflicting research literature or ill-informed and vaguely written textbooks. This
may be particularly the case with some of those misconceptions identified here, such as lactate metabolism and determinants of endurance performance. For example, the function of
lactate was the subject of a Point-Counterpoint debate between established researchers in recent editions of the Journal
of Applied Physiology in 2006 (1, 9 11). Furthermore, some
O2 max as the most important determinant of
authors still cite V
endurance performance (12) despite the wealth of research
evidence supporting the lactate threshold as the most important
predictor (2). In a similar manner to teachers in the classroom,
textbook authors should also strive for precision and clarity in
their words when drafting texts. Having an awareness of
common misconceptions and an appreciation of students understanding would appear to be a good starting point when
undertaking the writing process.
Experiences outside of the classroom have also been postulated as possible sources of misconceptions (16). This could
potentially be the case with the present study with areas such
as lactate and fatigue or with integration of lipid and carbohydrate metabolism. For example, many sports commentators and
members of the general public frequently report buildup of
lactic acid as a cause of fatigue during competition. The wealth
of advertisement campaigns promoting the importance of carbohydrate sport drinks for optimal performance also create the
perception that lipids are not an important fuel source during

145

sport and exercise. It is, of course, difficult to say whether

reasons such as these are the origin of those misconceptions
identified here. Nevertheless, as teachers and scientists, we
have the responsibility to correctly inform the general public
and media of relevant research findings.
It should also be noted that many of the students studied here
exhibited correct answers to the multiple-choice questioning
but upon justifying their reasoning were unable to provide
evidence of understanding behind the topic in question. In such
circumstances, the extent of the misconception identified therefore appears underestimated. In agreement with Michael et al.
(17), we also observed that students may understand less
than they appear to know. These data suggest that students
may have been able to memorize a particular fact they have
read in a textbook or heard in the lecture theater but have not
developed an understanding of how the fact has arisen.
Regardless of the precise source of the misconception, it is
essential that we are aware of the existence of the misconception in the first instance. Indeed, it is possible that many of the
current teaching staff involved in delivering those modules in
question in the present study may have been unaware of the
presence of the misconception. Furthermore, if not aware of
such basic misconceptions, it is likely that such staff therefore
pitch the lecture at a level that is beyond the current level of
student understanding. Formal identification of misconceptions
would therefore seem an appropriate and invaluable introductory activity for which to implement to understand the learners
needs and current level of understanding while also promoting
an aligned curriculum.
Potential teaching strategies. Once a misconception has
been identified, the logical progression is to formulate teaching
strategies to remediate and/or prevent a reoccurrence for future
years. Suggested teaching approaches include active laboratory
experience to provide an understanding of the particular phenomena and also an interactive learning environment in the
classroom (3, 15, 21). Where students do not have access to
appropriate laboratory instrumentation, it has also been suggested that teaching with classic papers can lend itself to the
exercise physiology and biochemistry discipline. For example,
Brown (5) reported how teaching with the classic paper of
Gollnick et al. (7) was especially useful for illuminating the
exercise-specific differences in bioenergetic enzymes, muscle
fiber type, and fitness characteristics that exist between untrained and trained individuals. Given the nature (and also the
interrelationships) of the misconceptions identified here, all of
the above approaches appear suitable.
Table 4. Percentages of students at each level of study who
displayed a misconception in understanding to questions 19
Student Population
Misconception
Question

Level 1

Level 2

Level 3

Question 1
Question 2
Question 3
Question 4
Question 5
Question 6
Question 7
Question 8
Question 9

85
87
44
100
84
56
63
81
78

80
50
43
95
75
50
84
61
54

60
19
72
97
90
57
68
67
80

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Limitations of the study design. The present study may be

limited in terms of the wording of questions in our Misconceptions Inventory. For example, we have previously discussed
how the wording of the question relating to contractile processes may have confused the student. It is also possible that
the question testing students understanding of when lactate
was made was misleading given that students may have interpreted this to mean predominantly made. Clearly, we should
strive for precision and clarity in our wording and also design
questions that more directly test the misconception being
targeted. For example, in this instance, it would have been
more beneficial if such a question had graphs depicting what
happens to the lactate concentration under conditions of hypoxia, normoxia, anoxia, and exercise so as to more robustly test
students understanding of lactate production.
Summary. This study represents the first known attempt to
undercover some of the misconceptions that SES students may
have when studying physiology- and biochemistry-related areas of the progression of their degree. It is only when we can
understand our students current levels of understanding can
we begin to formulate teaching strategies to facilitate meaningful and successful learning. Formative assessment of relevant topics via online multiple-choice questioning (delivered at
the beginning of a particular module or at appropriate points of
study) may be one potential user-friendly avenue of how to
obtain such information. These data also demonstrated that
students may appear to understand less than they know, and, in
this regard, it is essential that we focus on implementing
teaching learning activities that develop thought and understanding rather than making students remain as passive recipients of facts. An interactive classroom environment, active
laboratory experience, carefully chosen assessment tasks, and a
well-aligned curriculum would appear to be essential activities
for such higher-order learning to take place. Finally, once we
understand the level of understanding of our students, it should
be our duty as educators to provide comprehensible, easy-tofollow, integrative, and affordable texts to serve the undergraduate student population. Given the current direction of exercise
physiology and biochemistry research, such texts should be
drawn from a variety of scientific disciplines (e.g., molecular
biology, biochemistry, and physiology) and deal with various
levels of chemical organization (molecular to organism).
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